Antibiotics: handle with care! Insert logo of national institution Insert logo of national institution Fact 1. Resistance to antibiotics keeps increasing. This issue threatens the health and safety of patients in all healthcare settings in Europe. Fact 3. Up to 50% of all antibiotic use in European hospitals is unnecessary or inappropriate. Antibiotics are used inappropriately when: 35 The administration of antibiotics in critically ill patients is delayed; The spectrum of antibiotic therapy is either too narrow or too broad; The dose of antibiotic is either too low or too high; The duration of antibiotic therapy is either too short or too long; Antibiotic therapy is not reviewed after 48- 72 hours, or the choice of antibiotic is not streamlined when microbiological culture data become available. 30 25 20 15 10 5 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 S. aureus, meticillin-resistant (MRSA) E. coli, third-gen. cephalosporin-resistant K. pneumoniae, third-gen. ceph.-resistant Fact 4. Antibiotic stewardship programmes can lead to prudent use of antibiotics and reduce hospital costs. K. pneumoniae, carbapenem-resistant Figure 1. Trends of antibiotic resistance in bacteria from bloodstream infections, EU/EEA population-weighted average, 2002–2015. Source: EARS-Net, 2017. Hospitals that implemented an antibiotic stewardship programme, reported that they had reduced: Fact 2. Gram-negative bacteria, such as Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp., are becoming resistant to most available antibiotics. Inappropriate prescribing by 96%; Use of broad-spectrum antibiotics by 86%; Overall expenditures by 80%; Healthcare-associated infections by 71%; Length of stay or mortality by 65%; Antibiotic resistance by 58%. The emergence of bacteria resistant to multiple groups of antibiotics is particularly concerning, as infections due to these bacteria can be severe, costly and even fatal. These infections can lead to: Fact 5. You are responsible to ensure that antibiotics remain effective. Treatment failures, longer illnesses, prolonged stays in hospitals and increased morbidity and mortality; Mode adverse events, because more toxic antibiotics must often be used; Higher direct and indirect hospital costs. If you want to know more about what you can do or about the antibiotic stewardship programme in your hospital, contact [email address] or visit [hospital website/EAAD website]. This factsheet is supported by scientific evidence. Visit http://antibiotic.ecdc.europa.eu or scan the QR code.